East Coast Medical Network

Basic Physician Training 2017-18

Dr Paul HamorNetwork Director of Physician Training, East Coast Medical Network

Respiratory and Sleep Physician, Prince of Wales Hospital

• East Coast Medical Network• Philosophy

• Our Training Sites

• Relief

• Leave

• Our Training Program• Registrar Transition Support Program

• Procedural Skills Development

• Written Examination Preparation

• Clinical Examination Preparation

• Professional Development Support Program

• ECMN Annual Dinner

• FAQs

Overview

Our Philosophy

• Basic Physician Training are your formative years,

• Clinical experiences and knowledge acquired during this time help shape your career path and future life as a physician.

• Our aim is to guide you to become confident and competent advanced trainees and future physicians.

• Being a confident and competent registrar underpins success in the RACP Examinations.

Shellharbour Hospital

Prince of Wales HospitalSydney HospitalRoyal Hospital for Women

Port Macquarie Base Hospital

Lismore Base HospitalECMN Hospitals 2017

Our Network - 2017

Hospital Positions

Prince of Wales Hospital 21

Royal Hospital for Women 1

Sydney Hospital 1

Port Macquarie Base Hospital 6

Lismore Base Hospital(shared with Northern Sydney Coastal)

2

Shellharbour Hospital(shared with Illawarra Medical Network)

2

Total 33

Our Structure

East Coast Medical Network

Prince of Wales Hospital

Sydney HospitalRoyal Hospital

for WomenPort Macquarie

HospitalLismore Hospital

Shellharbour Hospital

The 2017 ECMN Team

Dr Paul Hamor

Network Director of Physician Training

Respiratory & Sleep Physician

Ms Helen Stavrou

Network Training and Education Manager

Port Macquarie Base Hospital

Terms:

General Medicine (4 positions)

Gastroenterology (1 position)

Cardiology (1 position)

UNSW Rural Clinical School

DPE: Dr Leigh Dahlenburg, Gastroenterologist

Shellharbour Hospital

DPE: Dr Andrew Jones, Respiratory PhysicianAMA Supervisor of the Year 2014 nominee

Terms: General Medicine (2 positions)

Shared site with Illawarra Medical Network

Lismore Base Hospital

Terms:

Medical Oncology/Haematology

Nephrology

Shared site with Northern Sydney Coastal Physician Training Network

DPE: Dr Adam Blenkhorn, Cardiologist

Sydney Hospital

Terms:

General Medicine (1 position)

DPE: Dr Greg Kaufman, Respiratory & General Physician

Royal Hospital for Women

Terms:

Obstetric Medicine & Endocrinology (1 position)

Prince of Wales Hospital

Prince of Wales Hospital Team

Adele RobertsAdministrative OfficerAssistant to the DPE

Dr Kate WebberClinical Superintendent & Medical Oncologist

A/Prof. Jeffrey Post POWH Director of Physician EducationInfectious Diseases Physician 2014 AMA Supervisor of the Year Nominee

• Cardiology

• Endocrine/Obstetric Medicine

• Geriatrics

• Gastroenterology

• Haematology

• Infectious Diseases / Immunology

• Intensive Care Unit

• Medical Oncology

• Neurology

• Palliative Care

• Respiratory

• Resp/Spinal Medicine

• Nephrology

Prince of Wales - Terms

• Is not a term of nights or evenings

• Aim to give you “pods” of specialty experiences during relief term

Relief Term

Leave

• 4 weeks of annual leave / year• 2 weeks in the 1st 6 months of the year; and

• 2 weeks in the 2nd half of the year

• Exceptions only for significant life events eg: your wedding, children etc…

• 7 days of study leave / year = 14 days over 2 years of training• 2 weeks in 2017, for use during the revision courses

• 1 week in 2018 clinical year, at a time you can preference

• Preferences for 2017 are submitted in October and include• “Urban” Term preferences

• “Rural” Term preferences

• Annual Leave preferences

• Study Course preferences

• Over the 2 year program, ECMN trainees will be required to complete a minimum of 3 terms away from Sydney.

Preferences

ECMN training program

Our 3-year Support Program

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar

Transition Support

Program

Videoconferenced

Written Examination

Preparation Program

Written Examination

Preparation

Program

PSDP

Clinical Examination

Preparation

Program

Professional

Development and

Support Program

Written Exam

Clinical Exam

Registrar Transition Support Program

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar Transition

Support Program

Videoconferenced

Written Examination Preparation

Program

Written Examination

Preparation

Program

PSDP

Clinical Examination

Preparation

Program

Professional

Development and

Support Program

Starting as a Registrar…

ECMN Registrar Transition Support Program

• Optional Web Based Tuition Program

• Program aim: to equip you with the knowledge to handle the most serious & common medical problems from day 1 as a medical registrar

• Structured preparation program aimed at BPT1s

• Run by ECMN for BPT1s • from October-December

• for all future ECMN trainees

• Aim to run this by webcast/GoogleChat

• Includes structured clinical exercises• We can sign off your mini-CEX in the process!

RTSP – Likely Topics

Common after-hours scenarios

• STEMI in rural locations

• Arrhythmias

• Acute Stroke

• Respiratory Failure & BiPAP

• Diabetic Ketoacidosis

• Shock & Sepsis

Professional topics

• Leading a team,

• Teaching on the run

• JMOs in difficulty

Investigation Interpretation

• ECG

• CXR

• Blood Chemistry

Procedural Skills Development

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar

Transition Support

Program

Videoconferenced

Written Examination Preparation

Program

Written Examination

Preparation

Program

PSDP

Clinical Examination

Preparation

Program

Professional

Development and

Support Program

Procedural Skills Development

• Central Lines

• Arterial Lines

• Paracentesis

• Thoracocentesis

• Chest Drains

• Lumbar Puncture

• Joint Aspiration

• Non-Invasive Ventilation

• Tracheostomy Care

Written Examination Preparation Program

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar

Transition Support

Program

Videoconferenced

Written Exam Program

Written Examination

Prep Program

PSDP

Clinical Examination

Preparation

Program

Professional

Development and

Support Program

• Network-wide Protected Teaching Time (Wednesday 3-5pm)• All lectures are videoconferenced throughout the network

• Program parallels and augments the RACP’s PEP lecture series

• Mixture of interactive sessions, MCQs, workshops & lectures

Written Exam Preparation Program

Lecture Program - example

PEP Lecture Series - Cardiology

• Ischemic heart disease

• Cardiomyopathies & Cardiac genetic testing for channelopathies and

• Valvular Heart Disease

• Pacemakers and ICD

• Heart failure and transplantation

• Cardiac CT and MRI

ECMN Teaching Program - Cardiology

• ECG interpretation Workshop

• Arrhythmias on the Ward

• Cardiology MCQ Session

• Basic Sciences of Cardiology

• Meet the Expert Q&A

Weekly Video-conference:

Online ChatForums:

Slack

Monday Clinical Pearls Program

• Hot topics are covered during this meeting

• Eg:• Pulmonary Function Testing

• Tumour Markers – the when and why

• Syphilis – understanding the serology

• Assessing & Understanding performance status

• Interpreting Chest imaging - like a pro!

• Assessing the undifferentiated patient

Tuesday BPT Case Conference• New addition for 2016

• 30 minutes case discussion and presentation

• Rostered structured presentation of one of your inpatients• 10 minute presentation

• Discussion of diagnostic and management issues

• Review of investigations, their meaning and interpretation

Hospital Wide Education Opportunities

Mon 0800 BPT Clinical Pearls Tutorial

1515 Nephrology Clinical Meeting

1600 Neurology Grand Rounds

Tues 0800 BPT Case Conference

0800 Cardiology Dept. Clinical Meeting

1200 Sleep Clinical Meeting

1230 Haematology Seminar

1300 Respiratory Radiology Meeting

Wed 0800 Medical Grand Rounds

1500 BPT Protected Teaching

Thu 0800 Respiratory Dept. Clinical Meeting

0800 Oncology Grand Rounds

0800 Cardiology Meeting

0800 Infectious Diseases Dept. Clinical Meeting

0815 Bone Marrow Morphology Session

1215 Haematology Journal Club

1300 Infectious Diseases Radiology Meeting

1730 RACP PEP Lectures

Fri 0800 Jaundice Breakfast

1200 Respiratory Pathophysiology Meeting

1500 Rheumatology Clinical Meeting

Clinical Examination Program

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar

Transition Support

Program

Videoconferenced

Written Examination Preparation

Program

Written Examination

Preparation

Program

PSDP

Clinical Examination

Prep Program

Professional

Development and

Support Program

Clinical Examination Program

• Long case masterclasses

• Short case masterclasses

• Rostered short cases and long cases

• Dedicated Weekly Neurology short-case teaching

• Neuro-ophthalmology

• Radiology teaching

• ECG sessions

• Group long cases

• Specialty short case days

• Saturday Morning Exam-style Short & Long Cases

Long Case Masterclasses

• How to do a long case

• Reinterpreting the narrative

• The social history

• Deriving the issues list

• Discussing management

• Discussing prognosis

• Answering questions

Rostered Practice Cases

• Weekly Consultant long cases

• Short cases with Advanced Trainees

Saturday Cases

Group long cases

• Multiple Sclerosis

• Haemoglobinopathy

• Rheumatoid Arthritis

• Renal Transplantation

• SLE / Autoimmune

• Cystic Fibrosis

• Coronary Diseases

State Based Masterclasses

• HIV

• Cystic Fibrosis

• Bone Marrow Transplant

• Heart Transplant

• Liver Disease

Specialty short case days

• Cardiology

• Rheumatology

• Neurology

• Respiratory

• Mixed Specialty Day

Outpatients brought in

Mimics exam conditions

Consultant & AT examiners

Radiology Teaching

• CT Head

• MRI Head

• Abdomen

• Musculoskeletal imaging

• Chest imaging

• Radiology Review session

ECG Teaching

• 4 dedicated ECG teaching sessions for short-case discussions

Neurology Program

• Weekly neurological examination teaching• Prof Paul Spira, Dr Sean Watson & Dr Will Huynh

• Weekly Neurology Grand Rounds

• Neuro-opthalmology Saturday

Putting it all together

Professional Development Support Program

Term 1 Term 2 Term 3 Term 4

BPT 1(2016)

BPT 2(2017)

BPT 3(2018)

Registrar

Transition Support

Program

Videoconferenced

Written Examination Preparation

Program

Written Examination

Preparation

Program

PSDP

Clinical Examination

Preparation

Program

Professional Development

Support Program

Professional Development:

• Curriculum Vitae writing

• Job Interview Skills

• Research opportunities

• Teaching & Presentation skills refresher

ECMN Mentor Program

• Consultant Mentor• Assigned a mentor at the beginning of the year

• Matched to your longer term interests and style

• Only on request

• Advanced Trainee Mentor• Assigned during the clinical exam preparation program

• Used as a guide through the ECMN program

• Can use as a tutor if the AT is willing.

Social Events:

ECMN Annual Dinner

ECMN Dinner 2016

• 3-cohorts of BPTs together

• Held at a prestigious venue• 2016 – Establishment, Sydney

• 2015 – Manta, Woolloomooloo

• 2014 – Zest, Point Piper Yacht Club

• 2013 – Pink Salt, Double Bay

• Invited speakers

• Sponsored for BPTs

Frequently asked questions

“Are there opportunities

for teaching?”

YES

Teaching is an expectation

All our hospitals are teaching hospitals affiliated with Medical Schools – UNSW

Conjoint Lecturer Status @ UNSW

UNSW Rural Clinical School PMBH

“Can I become involved in

Research next year?”

YES

Recent publications from our BPTs:Liam Back, Vinayak Nagaraja, Amit Kapur, Guy D. Eslick Role of decompressive hemicraniectomy in extensive middle cerebral artery strokes: a meta-analysis of randomized trials.Internal Medical JournalVolume 45, Issue 7, pages 711-717, 2015

Sonya Jung, Vinayak Nagaraja, Amit Kapur, Guy D. Eslick Associated between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis.Internal Medical JournalVolume 45, Issue 4, pages 409-416, 2015

Kiran Sarathy, Vinayak Nagaraja, Amit Kapur, Richard Szirt, Jwalant Raval, Guy D. EslickTarget-vessel vesus multivessel revascularization in ST-elevation myocardial infarction: a systematic review and meta-analysis.Heart, Lung and CirculationVolume 24, Issue 4, pages 327-334, 2015

Research – some tips for success

• Sept 2016 – Job offers released

• Oct 2016 –• Contact your BPT Network and ask for contacts in your preferred specialty

• Introduce yourself to the specialty and offer to assist with papers

• Ask if there are any short-term projects you could work on

• Nov 2016 – Jan 2017• Do any research at your chosen hospital

• Feb – August 2017• Do research and start to write up any papers

• August 2017+ • Finish writing and submit papers

“How else can I become involved”

Well…

How else can I get involved?

• ECMN Governance Committee

• POW Clinical Examination Project

• JMO Handover Education

• Intern Buddy Program

• JMO Research Committee

• POWH Education Strategy

• Medication Safety Committee

• And much more!!!

“What are ECMN’s pass rates

in the RACP Exam”

Written

86%Clinical

92%

Examination Results

Written Clinical

2011 95 % 83 %

2012 90 % 100 %

2013 82 % 88 %

2014 82 % 95 %

2015 84 % 94 %

2016 82 % ??

AVG: 86 % 92 %

“How many positions

are on offer for 2017?”

17 +2 ?

“Do you reserve BPT places for

Residents from ECMN Sites?”

NO

Prince of Wales

Wollongong

Port Macquarie

St GeorgeLiverpool

Westmead

Bankstown

Royal North Shore

Royal Prince Alfred

Nepean

St Vincent’s

Blacktown

Gosford

Orange

Interstate

Overseas

ECMN Trainee’s Hospital of Origin 2012-2016

Prince of Wales

Wollongong

Port MacquarieSt George

Liverpool

Westmead

Bankstown

Royal North Shore

Royal Prince Alfred

Nepean

St Vincent’s

Blacktown

Gosford

Orange

Interstate

Overseas

28%

12%

“How many BPTs are subsequently

employed as Advanced Trainees?”

Prince of Wales

Other

ECMN Graduates who were subsequently employed at POWH 2012-2016

55%45%

ECMN Graduates choice of Speciality 2012 – 2016

Haematology

Endocrinology

Neurology

Oncology

Renal

Rheumatology

General Medicine

RespiratoryImmunology

Sexual HealthCardiology

Gastroenterology

Geriatrics

Infectious Diseases

AT positions (POWH & related Networks), Fellowship, PhD

Cardiology (network)3 ATs,

1 Interventional Fellow, 1 Cardiac Imaging Fellow, 3 Masters, 2 PhD

Endocrinology 2 ATs

Gastroenterology2 ATs,

1-3 Clinical Research Fellows

Geriatrics 6 ATs

Haematology (network)3 ATs

6 PhD @ Lowy Research Institute

Infectious Diseases2 ATs

1 HIV Clinical Fellow, Dual Microbiology training

Medical Oncology (network)2 ATs

1 Fellow position

Neurology1 AT

1 Clinical Neurophysiology Fellow, 1 Epilepsy Fellow

Palliative Care 2 ATs

Renal medicine (network)2 ATs3 PhD

Rheumatology1 AT

1 Fellow

Respiratory, Sleep medicine3 ATs1 PhD

“What qualities do you

look for in a trainee”

The Top 3 things Dr Hamor looks for in prospective trainees

1. Clinical Competency

2. Team player

3. Ability to lead an arrest team

“Is there anything I can improve on

before starting next year”

I highly recommended the ALS 2 Course prior to starting as a Medical Registrar

“I can’t decide what network to choose!

Do you have any advice?”

1 - Workload

Too Busy

Too Light

ECMN

“How do you select people to be

employed in ECMN?”

300-400 applicants

90 interviewed

17 positions

Positions

How to get an interview with ECMN

• Things we do NOT use• If you had a pre-meet or not

• If you attended our information night or not

• If you were a JMO at Prince of Wales

• Things we DO look at:• How you answer the Selection Criteria

• Your curriculum vitae.

How to do well at interview

• Practice

• Ask about previous questions

• Consider your responses

• Answer the question, the whole question,

and nothing but the question !

Preferencing

http://www.nrmp.org/match-process/match-algorithm/

• Based on the National Resident Matching Algorithm • was the basis for awarding the 2012 Nobel Prize in Economic Sciences

• “Applicant-Proposing” system • preferences & rank order expressed by applicants initiate placement to programs

• Program preferences are secondary in the process to applicant preferences

• No applicant could obtain a better outcome than that produced by the algorithm

The Algorithm

• The program attempts to match an applicant with their #1 preference

• A Match occurs if • The program has unfilled positions OR

• The program is tentatively filled, but the applicant is ranked higher than other applicants.

• If a match to the #1 preference cannot occur, their #2 preference is checked etc…

Dawson Chen Perez Patel

1. Memorial 1. Pikesville 1. Pikesville 1. Albany

2. Albany 2. Albany 2. Albany

3. Pikesville 3. Memorial

Pikesville (1 position)

Memorial (2 positions)

Albany (2 positions)

1. Perez 1. Perez 1. Chen

2. Patel 2. Dawson 2. Dawson

3. Chen 3. Patel 3. Perez

4. Patel

Applicant Preferences Program Preferences

Pikesville (1 position)

Memorial (2 positions)

Albany (2 positions)

1. 1. 1.

2. 2.

MATCHES

The Algorithm Tutorial

http://www.nrmp.org/match-a-to-z/video-tutorials/about-the-matching-algorithm-tutorial/

The Algorithm Tutorial Video

• Things to note from the video:• Pikesville only had 1 position, but that didn’t stop Chen and Perez trying to

go there, because it was their most desired preference

• Chen was not disadvantaged by listing Pikesville first, and subsequently got a position at his second preference, Albany.

• Patel put himself in a risky position, not having any back up, and was lucky to get a position with Albany as he was their lowest rank candidate

Preference Match - Summary

• Preference in the order of WHERE you would like to work,• (NOT where the most positions are)• Your likelihood of getting a position is NOT influenced by the number of

positions available.• Don’t rank “safe choices” higher than your preferred choice.

• The algorithm will maximise YOUR preferences

• You cannot ‘game’ the system

• Make sure you have a backup option!

• http://www.nrmp.org/match-process/match-algorithm/

Great variety of training locations & clinical rotations

Comprehensive training program, with excellent results

Balanced training experience, with broad clinical exposure

An enthusiastic team, ready to support YOU

For more information:

www.seslhd.health.nsw.gov.au/East_Coast_Medical_Network

Ms Helen Stavrou, Network Training and Education Manager

(02) 9382 2041, helen.stavrou@health.nsw.gov.au

Dr Paul Hamor, Network Director of Physician Training

(02) 9382 2251, paul.hamor@health.nsw.gov.au

Join the ECMN team for 2017!